Facing the medical desert of Allier, why not a health check?

It is 8 in the morning when Olivier, 49, enters the premises of the ISBA* of Moulins, the partner association of Health Insurance, specialized in health checks. The man feels fluffy, he hasn’t eaten. And he’s diabetic. But he had no choice, he had to come on an empty stomach so that the exam would go smoothly.

Without a doctor since his arrival in the Bourbon capital eight months ago, he obtains teleconsultations here and there in the pharmacy, but cannot find a doctor who will accept him. Even after carefully listing and calling everyone in the area. While waiting to find the Grail, the teleconsultations allow him to renew his prescription to cure his type 2 diabetes. But this medical wandering could harm him. So when Olivier received an email from the ISBA suggesting a follow-up visit, he immediately made the appointment. Vision and hearing are analyzed, in addition to a blood test, a urine analysis and prevention on a case-by-case basis, by a doctor and a nurse.A blood test for Olivier

The social security sends a certain number of “vulnerable” profiles to the health centre. These are, for example, people in a precarious situation, to whom the ISBA sends a proposal for health checks via email, post or telephone. Olivier, after working as a carpenter, had to quit due to his health five years ago. After this stop he lived for some time in his car, before finding lodgings in Moulins. Now he receives a small disability pension. The CPAM then sent his contact details to the health examination centre.

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But precarious profiles are not the only ones welcome.

“Anyone over the age of 16 enrolled in the Social Security can make an appointment with us”

Anissa Bentaoune Faure (Head of Allier Health Examination Centers)

Especially since the health check is fully reimbursed by the social security. Not even the patients have to pay any compensation. A godsend when you know that 10% of Bourbon citizens have no attending physicians, who allow greater reimbursements for many consultations.Hearing is also evaluated in an adapted machine.

This situation shouldn’t get better: in the Allier there would be 105.2 general practitioners for every 100,000 inhabitants, against 120.3 of the national average, according to the Directorate General for the provision of care. Worse still, half of them are over 60 and 17% would even combine the practice of medicine with retirement, according to the Atlas of Medical Demography in France.
Due to this shortage of doctors, every inhabitant of Allier is entitled to a reimbursed check-up every three years, while for the other departments it is every five years. It is also not uncommon, according to Anissa Bentaoune Faure, for some patients to show up once every three years and that this checkup is the only time they see doctors. But most of the inhabitants are completely unaware of the existence of these 100% reimbursed health tests. Thus, especially in rural areas, we see that people take much less care of themselves. Result: due to lack of early diagnosis, “in the Allier, for example, there is an excess of mortality from cervical cancer”, deplores the head of the examination centres.

In ten years Allier will lose a third of its dentists: “We reject patients every day”

The center moves to the countryside

To try to remedy this problem, the ISBA travels at least once a week to the Bourbon countryside, to towns far from urban centres, such as Le Donjon and several other towns. But it has two fixed addresses where checks are carried out every weekday morning, in Moulins, rue Achille-Roche and in Montluçon, avenue Marx-Dormoy.
Two hours have passed, Olivier, the forty-year-old diabetic has finished his exams, now he has the right to a snack.

A coffee in one hand, a Breton biscuit in the other, he takes stock of his medical records.

Obviously I was right to come, I’ll stay hospitalized for a few days.

Oliver, 49 years old (empty)

His diabetes treatment is totally deregulated. She suspected a little: “For a month my diabetes rate has not been manageable with my machine, because it has exceeded its limit.” She has also lost 8 kg in two months and her vision has also decreased dramatically. 4 and 6 out of 10, up from 10 out of 10 before. A possible consequence of diabetes. However, “since I saw the doctor rather worried, I have fewer problems going to the hospital to ask them to get my treatment back on track”.
As for the attending physician who is missing, the nurse at the preventive health visitor center also took the opportunity to set up a file and write a letter to the health insurance to remedy this problem. He knows it will be very complicated to obtain, but thanks to this file Olivier will be in the archives of the Secu. He will then be entitled to medical reimbursements at the same rate as the attending physician. Better than nothing.

ISBA Health prevention: Burgundy Auvergne health institute.

The objective of the health check: to prevent rather than cure
Anissa Bentaoune Faure is responsible for the Allier Health Examination Centers.
Through the ISBA Santé Prévention association, health insurance allows more than 2,700 Bourbon citizens to take stock of their health for free each year.
About two hours is the time it takes for the doctors and nurses of ISBA Santé Prévention to examine you from all angles.

But before this appointment, you have some work. Fifteen days before, you receive a fairly comprehensive questionnaire, which you must complete. Don’t panic :

Put what you know about your medical and vaccination history Anissa Bentaoune Faure

(Head of Allier Health Examination Centers.)

During your visit to the examination center, rue Achille-Roche in Moulins or avenue Marx-Dormoy in Montluçon, you will meet a doctor. This will shape the rest of the exam based on the questionnaire and your risk factors. “If your parents are diabetic and you are overweight, for example, he will prescribe you a blood sugar test, or if you got a tattoo in a ‘doubtful’ salon, for example an HIV and liver test.

Condoms for the young, anti-fall flyers for the elderlyThe objective of this health check is above all prevention. Young people are made aware of the risks of sexually transmitted infections and walk away with few condoms. A way to prevent health risks for the individual, but also for society.

The nurse and the doctor give targeted advice
To the older ones, the doctor explains the risks of falling, how to protect yourself by adapting your accommodation and how to get up again.
He also recommends palpation of the breast and can take smears if the patient wishes. An electrocardiogram may also be performed. “Sometimes we call 911 after detecting an anomaly.”
But rest assured “95% of checks are fine, no bad news”.

However, one or two carriers of the AIDS virus or a dozen colorectal cancers are still detected every year in the ISBA centers in Allier.
In addition, the doctor can also retrieve expired vaccines.
In short, “we offer, people have, they become actors in their health”. The purpose of this assessment is to prevent rather than cure.

And this is somewhat the limit of prevention.

We are not there to force people to stop smoking or get vaccinated, we are not there to judge them. ANISSA BENTAOUNE FAURE

(Head of Allier Health Examination Centers)

From fifteen days to three weeks after the exam, you will receive the results of your tests by mail. And your treating doctor, if you have one, gets a copy, only if you want it. Likewise, the results are only passed on to the health insurer with your consent.

Information and appointment at or at isbamoulins@isbasante.com

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